Alcohol consumption and HIV disease prognosis among virally unsuppressed in Rural KwaZulu Natal, South Africa

IF 0.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Manasseh B. Wireko, J. Hendricks, K. Bedu-Addo, M. Van Staden, E. A. Ntim, S. Odoom, I. Owusu
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引用次数: 0

Abstract

Background The effect of alcohol consumption and human immunodeficiency virus (HIV) disease prognosis has been examined in several studies with inconsistent findings. We sought to determine the effect of alcohol consumption on HIV disease prognosis by examining CD4+ T cell count/µL (CD4+ count) and HIV RNA concentration [HIV viral load (VL)] independent of anti-retroviral therapy (ART). Methods A secondary analysis was performed on a cross-sectional survey data of 1120 participants between 2018 and 2020. Questionnaires were used to obtain the participants' history of alcohol consumption. Blood samples were assayed for CD4+ T cell count/µL (CD4+ count) and HIV RNA concentration (HIV viral load). The history of alcohol consumption was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy-alcohol consumers. Age, cigarette smoking, gender, and ART use were considered potential confounders. Participants were categorized into two cohorts for the analysis and a multivariate logistic regression was used to establish relationships among virally unsuppressed participants who were ART-experienced and ART-naïve. Results A total of 1120 participants were considered for analysis. The majority were females (65.9%) between 15–39 years (72.4%). The majority were non-smokers and non-alcohol consumers (88% and 79%, respectively). ART-experienced females had an increased risk of having a higher VL (VL > 1000). This finding was statistically significant [RR, 0.425, 95% CI, (0.192–0.944), p-value, 0.036]. However, ART-experienced participants aged above 64 years had an increased risk of having a lower VL (VL < 1000 copies/mL) and a lower risk of having a higher VL (VL > 1000). However, ART-naïve participants aged between 40–64 years had a significantly lower risk of having higher CD4 count (CD4+ > 500 cells) and an increased risk of having a lower CD4 count [OR, 0.566 95% CI, (0.386–0.829), p-value, 0.004]. History of alcohol consumption did not have a significant effect on CD4+ cell count and VL in neither the ART-experienced nor the naïve cohort. Conclusions Female middle-aged people living with HIV (PLWH) are more likely to have a poorer HIV disease state, independent of alcohol consumption. Alcohol consumption may not have a direct effect on CD4+ cell count and VL in either ART-naïve or experienced patients.
南非夸祖鲁纳塔尔省农村病毒未被抑制人群中的酒精消费与HIV疾病预后
背景:饮酒和人类免疫缺陷病毒(HIV)疾病预后的影响已经在几项研究中进行了检验,但结果不一致。我们试图通过检测独立于抗逆转录病毒治疗(ART)的CD4+ T细胞计数/µL (CD4+计数)和HIV RNA浓度[HIV病毒载量(VL)]来确定饮酒对HIV疾病预后的影响。方法对2018 - 2020年1120名参与者的横断面调查数据进行二次分析。通过问卷调查获得参与者的饮酒史。检测血样中CD4+ T细胞计数/µL (CD4+计数)和HIV RNA浓度(HIV病毒载量)。酒精消费史分为非酒精消费者、非重度酒精消费者和重度酒精消费者。年龄、吸烟、性别和使用抗逆转录病毒治疗被认为是潜在的混杂因素。参与者被分为两个队列进行分析,并使用多变量逻辑回归来建立病毒未受抑制的参与者(有art经验的参与者和ART-naïve)之间的关系。结果共纳入1120名受试者进行分析。15 ~ 39岁以女性居多(65.9%),占72.4%。大多数是不吸烟和不饮酒的消费者(分别为88%和79%)。接受过art治疗的女性VL升高的风险增加(VL > 1000)。这一发现具有统计学意义[RR, 0.425, 95% CI, (0.192-0.944), p值,0.036]。然而,年龄在64岁以上的接受过art治疗的参与者具有较低VL (VL < 1000拷贝/mL)的风险增加,而具有较高VL (VL > 1000)的风险较低。然而,年龄在40-64岁之间的ART-naïve参与者具有较高CD4计数(CD4+ > 500细胞)的风险显着降低,并且具有较低CD4计数的风险增加[OR, 0.566 95% CI, (0.386-0.829), p值,0.004]。在接受art治疗的患者和naïve队列中,饮酒史对CD4+细胞计数和VL均无显著影响。结论女性中年HIV感染者(PLWH) HIV疾病状态较差的可能性较大,与饮酒无关。饮酒可能对ART-naïve或有经验的患者的CD4+细胞计数和VL没有直接影响。
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来源期刊
AIMS Medical Science
AIMS Medical Science MEDICINE, RESEARCH & EXPERIMENTAL-
自引率
14.30%
发文量
20
审稿时长
12 weeks
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